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Overview

Is this topic for you?

This topic provides an overview of upper and middle back pain. If you have low back pain or neck pain, see the topic Low Back Pain or Neck Pain.

What is upper and middle back pain?

Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your Arthritis Curehow to Arthritis Cure for rib cage.

Your ribs attach to a long, flat bone in the center of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.

The for 1 last update 2020/05/28 upper and middle back (called the thoracic spine) has:The upper and middle back (called the thoracic spine) has:

  • 12 vertebrae. These bones attach to your rib cage. They make up the longest part of your back.
  • Discs that separate each vertebra and absorb shock as you move.
  • Muscles and ligaments that hold the spine together.

See a picture of the spine.

Upper and middle back pain is not as common as low back pain or neck pain, because the bones in this area of the back don''re having a hard time doing your daily activities, you may need to take a prescription pain medicine. Surgery is seldom used to treat upper and middle back pain.

How can you care for yourself at home?

Arthritis Curehow to Arthritis Cure for There are several things you can do at home to help reduce your pain. For example:

  • Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly.
  • Use over-the-counter pain medicines, such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
  • Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling.
  • Exercise. Exercises that stretch and strengthen the muscles in your back, shoulders, and stomach can help improve your posture, decrease your chance of injury, and reduce pain.
  • Practice good posture. Be sure to stand or sit tall. Don''t need treatment. If you get worse, you and your doctor will decide what to do next. If your back pain is mild to moderate, it probably will get better on its own. You can try home treatment to relieve your symptoms. If you don''t manage at home.

Arthritis Curehow to Arthritis Cure for Who to see

Health care professionals who often diagnose the cause of back pain include:

If your back pain is severe or long-lasting, health professionals who can treat you include:

You can also get care from:

Exams and Tests

Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a physical exam. Your doctor may also order an imaging test to find out if something such as a broken bone or a herniated disc is causing your pain.

The type of imaging test you have depends on what kind of problem your doctor suspects. You may have one or more tests, such as:

More tests may be done to check for other possible causes for your pain.

Treatment Overview

There are many treatments for upper and middle back pain. What works for someone else may not help you. Work with your doctor to find what is best for you.

Treatment for upper and middle back pain is based on:

  • How bad your symptoms are.
  • How much your symptoms prevent you from doing your daily tasks.
  • How well other treatments have worked.

Treatment for mild to moderate pain

Arthritis Curehow to Arthritis Cure for In most cases, people with mild to moderate upper and middle back pain can manage their symptoms with:

  • Over-the-counter pain medicines , such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin), to reduce pain. But if these don''t get better or it gets worse, your doctor may recommend:

    • Prescription medicines, such as opioids, to help reduce pain.
    • Muscle relaxants to help reduce pain and muscle tension and improve mobility. These can help with severe muscle spasms that happen when the back pain starts (acute phase).
    • Antidepressants, such duloxetine, to help treat long-lasting (chronic) back pain.
    • Steroid shots to help reduce swelling and relieve pressure on nerves and nerve roots. But there is little evidence showing that these shots can help control back pain.

    Arthritis Curehow to Arthritis Cure for In some cases, a back brace may be used to support the bones in the spine after a fracture.

    Surgery is seldom used to treat upper and middle back pain. If your doctor recommends surgery, the type will depend on the problem you have. Surgery choices may include:

    • Kyphoplasty or vertebroplasty . Bone cement is injected through a needle into the broken vertebrae to try to stabilize the bone. These surgeries are not done very often, because most fractures heal on their own. And there is no evidence that kyphoplasty or vertebroplasty are better than nonsurgical treatment.footnote 2
    • Herniated disc removal . It removes the portion of the disc that is herniated and pushing into the spinal canal. In most cases, herniated discs that occur in the upper and middle back are small and don''t relieve back pain better than staying active. And bed rest of more than a couple of days can make your back pain worse and lead to other problems, such as stiff joints and muscle weakness.
    • Use over-the-counter for 1 last update 2020/05/28 pain medicines over-the-counter pain medicines , such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
    • Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling. You might want to switch back and forth between heat and cold until you find what helps you the most.
    • Exercise. Ask your doctor or a physical the 1 last update 2020/05/28 therapistphysical therapist about what kinds of exercises you can do to stretch and strengthen the muscles in your back, shoulders, and stomach. These muscles help support your spine. Strong muscles can help improve your posture, keep your body in better balance, decrease your chance of injury, and reduce pain.
    • Practice good posture . Poor posture puts stress on your back. Be sure to stand or sit tall, with your shoulders and your stomach pulled in to support your back. Don''t smoke. Smoking decreases blood flow and slows healing. If you need help quitting, see the topic Quitting Smoking.
    • Take extra care when you lift. When you must lift, bend your knees and keep your back straight. Avoid twisting. Keep the load close to your body.
    • Use a pain diary . Write down how your moods, thoughts, sleep patterns, activities, and medicines affect your pain. Having a record of your pain can help you and your doctor find the best ways to treat your pain.

References

Citations

  1. Gagnier JJ, et al. (2016). Herbal medicine for low back pain: A Cochrane review. Spine, 41(2): 116–133. DOI: 10.1097/BRS.0000000000001310. Accessed June 17, 2016.
  2. Esses SI, et al. (2011). The treatment of symptomatic osteoporotic spinal compression fractures. Journal of the American Academy of Orthopaedic Surgeons, 19(3): 176–182. Also available online: http://www.aaos.org/research/guidelines/guide.asp.

Other Works Consulted

  • Hansen TJ (2015). Thoracic compression fracture. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 3rd ed., pp. 211–216. Philadelphia: Saunders.
  • Mercier LR (2008). The back. In Practical Orthopedics, 6th ed., pp. 143–184. Philadelphia: Mosby Elsevier.

Credits

Current as for 1 last update 2020/05/28 of: June 26, 2019 Current as of: June 26, 2019

Author: Healthwise Staff
Medical Review:
William for 1 last update 2020/05/28 H. Blahd Jr. MD, FACEP - Emergency MedicineWilliam H. Blahd Jr. MD, FACEP - Emergency Medicine
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine

Current as of: June 26, 2019

Arthritis Curehow to Arthritis Cure for Author: Healthwise Staff

Medical Review:William H. Blahd Jr. MD, FACEP - Emergency Medicine & E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine

Gagnier JJ, et al. (2016). Herbal medicine for low back pain: A Cochrane review. Spine, 41(2): 116-133. DOI: 10.1097/BRS.0000000000001310. Accessed June 17, 2016.
Esses SI, et al. (2011). The treatment of symptomatic osteoporotic spinal compression fractures. Journal of the American Academy of Orthopaedic Surgeons, 19(3): 176-182. Also available online: http://www.aaos.org/research/guidelines/guide.asp.

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Upper and Middle Back Pain